CSS Care Ltd

Ratings

• Overall

  Requires improvement

• Safe

  Requires improvement

• Effective

  Requires improvement

• Caring

  Good

• Responsive

  Requires improvement

• Well-led

  Requires improvement

Our view of the service

CSS Care Ltd is a domiciliary care service providing personal care to adults with a range of support needs, in their own homes. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. The service was providing personal care to 15 people at the time of our inspection. The inspection was prompted in part due to concerns raised around governance and management at the service. We carried out assessment activity between 13 March and 4 April 2024; reviewing elements of the safe, effective, caring, responsive and well-led key questions. We identified 5 breaches of the legal regulations in relation to; safe care and treatment, staffing, recruitment, governance and complaints. Incidents, accidents and complaints were not always reported or recorded meaning we could not be assured appropriate action had been taken. Medication records were poor, and safeguarding concerns were not fully investigated. We noted issues with staff training and supervision; and recruitment processes were not robust, meaning we could not be confident staff were capable or of good character. Information about people’s care needs and risks were not always available for staff to refer to, and sometimes details were inconsistent. There was a lack of regular auditing which meant the safety and quality of care was not effectively monitored. Policies were not being followed. During assessment, concerns with the management structure were identified. As such, the provider implemented immediate changes. The existing nominated individual stepped down and the manager took over this role. A nominated individual is responsible for supervising the management of the service on behalf of the provider. The provider intended to recruit a replacement manager. We have asked the provider for an action plan in response to the concerns found at this inspection.

People's experience of this service

We spoke to 4 people and 7 relatives about their experience of care provided by CSS Care Ltd. Several people and relatives shared information with us that was indicative of abuse or neglect, and confirmed action had not always been taken effectively in response to concerns raised. We also received comments about poor communication and how language barriers sometimes impacted people’s experiences. A person told us, “I feel safe and carers are respectful, apart from the odd 1 who finds it difficult because they can’t speak my language.” We received mixed feedback about staffing levels. A relative said, “There have been no missed or late visits. Visits are not rushed.” However, another relative responded, “About 6 months ago, staff spent only 4 minutes with [person] for a 20 minute call. Things are improving but I think they still use agency staff at weekends.” People and relatives were somewhat complimentary about their overall experience, and we received positive examples of staff supporting people in-line with their needs and preferences, improving outcomes. A relative told us, “Staff understand [person’s] dementia. They are tolerant and patient and are working on building up trust.” Another added, “The care that is delivered meets all needs and preferences. Social activities are encouraged and undertaken on a regular basis, it’s a big part of why [person] is still mentally alert.” People confirmed they were involved in care plans and reviews, and staff sought consent.